List 3 Isotonic Intravenous Solutions

D5W supplies what in cal/L?
It contains ? g of glucose?
How should D5W not be given and why?

1. 170 cal/L
2. 50 g of glucose
3. Should not be given in excessive volumes because it does not contain Na+ (or ANY electrolytes), therefore; the fluid dilutes the amount of Na+ in the serum. Brain swelling, or hyponatremic encephalopathy can develop rapidly and cause death unless recognized and treated promptly.

0.9 NaCl is not desirable when? Why?
Normal saline may used to treat what?

1. Not desirable as routine maintenance solution because it provides only Na+ and Cl-, which are provided in excessive amounts, which can result in increased Na and Cl levels.
2. May be used to expand temporarily the extracellular compartment if circulatory insufficiency is a problem; hypovolemic shock, diabetic ketoacidosis or bot Na and fluid loss.

Lactated Ringer's Solution contains what?
What is it used to treat? When is Lactacted Ringers Solution contraindicated?

1. Contains multiple electrolytes in about the same concentrations as found in plasma. This solution lacks magnesium and phosphate.
2. Used in treating hypovolemia, burns, fluids lost as bile or diarrhea and mild metabolic acidosis.
3. Hyperkalemic patients and lactic acidosis

Hypotonic

Hypovolemia

Implanted Port

a type of CVAD; subcutaneous injection port attached to a catheter; distall catheter tip dwells in the lower one third of the superior vena cava to the junction of the superior vena cava and the R. atrium. The proximal end of the port is usually implanted into a subcutaneous pocket of the upper chest wall. Implanted ports placed in the antecubital area of the arm are referred to as peripheral access system port.

Isotonic

Overhydration

Typing

Nontunneled Percutaneous Central Venous Catheters

a type of CVAD that has a short dwell time (3-10 days) may have double, triple or quadruple lumens, are more than 8 cm, depending on pt. size. Introduced through the skin into the internal jugular, subclavian, or femoral veins and sutured into place; are mainly used in critcal care and emergency settings

Peripherally Inserted Central Catheter (PICC)

a type of CVAD, more than 20 cm depending on the pt. size, that can be introduced into a peripheral vein (usually the basilic, brachial, or cephalic vein), and advanced so the distall tip dwells in the lower one third of the superior vena cavaand the R. atrium.

Peripheral Venous Access Device

a short, less than 3 inches peripheral catheter placed in a peripheral vein for ST therapy. This device is not appropriate for certain therapies such as vesicant chemotherapy, drugs classified as irritants or TPN.

Tunneled Central Venous Catheter

a type of CVAD intended for LT use, implanted into the internal or external jugular or subclavian vein, length of catheter is more than 8 cm (approximately 90 cm on average) depending on pt. size; tunneled in subcutaneous tissue under the skin (usually the midchest area) for 3-6 inches to its exit site

If any of the above symptoms are present what will need to occur? (in red)

What is the most common complication related to IV therapy?

What will you check for regarding bacteria or infection present? (in red)

check for local manifestations of redness, pus, warmth, induration, and pain that may indicated infection is present at the site. systemic manifestations will include chills, fever, tachycardia and hypotension that may accompany local manifestations at the site. If signs are present d/c and notify physician.